به نام خدا
Case report
A 37 years old female patient (G2L1)was admitted in gynecology urgance with chief complaint of RLQ pain , nausia, vomitting, shoulder pain, rectal pressure that have been started a few hours ago and hystory of faint
Serum beta hcg titrage was >250 one days ago
VITAL SIGN PR=125 BP=90/60 T=36.8(ORAL)
PHYSICAL EXAM PALE &ILL Obviouse tendernes & rebound tendernes in RLQ Vaginal exam: no vaginal bleeding, cervical motion tendernes was positive in right
Patient immediately went to operation room for emergency surgery with diagnose of ruptured EP & in pre shock situasion with 2 units packed cell.
During the surgery patient received 1 packed cell. Near the end of surgery patient have had hematuric bag with stable hemodynamic. Immediately transfusion of packed cell stopped &pack cell with a sample of patiet blood have sent to the blood bank.
IN recovery vital sign of patient was: PR=145 BP=70/50 TRANFUSION OF SERUM & MANITOL STARTED
MISMATCH TRANSFUSION OF ABO (A+ WAS INFUSED INSTEAD OF O+) REPORT OF BLOOD BANK MISMATCH TRANSFUSION OF ABO (A+ WAS INFUSED INSTEAD OF O+)
The patient has transported to the ICU. After 2 days ANORIC & RISENING OF CREATININ LEVEL was found as secondary findings (ATN)
LABORATORY FINDINGS Hb=7.7 , 7.4 , 6.7 , 7 , 9.2 , 8 ,7.5 , 8.6 , 7.1 , 6.9 , 8.3 Plt=203 , 68 , 77 , 93 , 74 , 94 , 212 , 354 , 419 , 520 , 482 Serum bete hcG=3127 Cr=1 , 2 , 2.2 , 4.2 , 3.4 ,5 , 4.7 , 6.3 , 5.5 , 7.9 , 7.8 , 8.2 , 4.6 , 3.1 ,2.7 , 2.4 , 2 , LDH=2778 COOMBS(D:NEG , IND:NEG)
At least patient has needee 7 times HEMODIALYSIS to recovery.